Inner Wellness Therapy LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

INNER WELLNESS THERAPY LLC

Practice address

180 Tices LN Ste 104
East Brunswick, NJ 08816-1345

Phone

(732) 598-6396

Fax

(732) 548-5859

NPI assigned

Mar 24, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Jennifer Rerngsamai, LCSW

Title

Provider/Owner

Phone

(732) 598-6396

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585526400000",
    "number": "1346877974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 SUNSET AVE",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571255",
            "telephone_number": "732-598-6396",
            "fax_number": "732-548-5859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 TICES LN STE 104",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161345",
            "telephone_number": "732-598-6396",
            "fax_number": "732-548-5859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNER WELLNESS THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A",
        "authorized_official_last_name": "RERNGSAMAI",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "732-598-6396",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Adolescent and Children Mental Health Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.